Unit 3 - Health Behaviour and Wellbeing

Lecture 3: Theories and Behaviour Change Interventions

• Personal responsibility involves health promotion and primary prevention initiatives beyond individual behaviours.
• Popular theoretical frameworks include attribution theory, theory of planned behaviour, self-efficacy theory, self-perception models, achievement goals theory, goal setting theories, health belief model, transtheoretical model, and health action process approach.

Table 15.1: Exercise Stages, Goals, and Sample Behavior Change Strategies

• Precontemplation: Goal is to begin thinking about changing; Strategies include providing information about the role of exercise in good health, strengthening the actual and perceived personal benefits, reducing perceived costs and barriers, fostering a personal value for exercise.
• Contemplation: Goal is to adopt regular exercise; Strategies include creating marketing campaigns with accurate, easy-to-understand guidelines for beginning an exercise program, offering activities to increase exercise self-efficacy (e.g., mastery experiences), and evaluating pros and cons of exercise.
• Preparation: Goal is to adopt regular exercise at an appropriate target level; Strategies include creating a thorough physical and psychosocial assessment (self-monitoring), establishing realistic goals, evaluating environmental and social supports and barriers, and addressing barriers accordingly.

The Health Belief Model

• A health behaviour model based on the belief that a health threat exists and that action will lessen the threat.
• Health threat factors include personal vulnerability and the severity of consequences.
• The model suggests individuals are more likely to change health behaviours if they believe they are at risk of illness and taking action will help.
• Healthcare professionals utilize this model to develop programs that promote health behaviour changes.

Theory of Planned Behaviour

• Assumes individuals act rationally, influenced by attitudes, subjective norms, and perceived behavioral control.
• These factors form the backdrop for decision-making, not necessarily consciously considered.
• Components include attitude towards the behaviour (positive or negative evaluation), subjective norm (perceived social pressure), and perceived behavioral control (belief in one's ability to perform the behaviour).

Social Cognitive Theory

• Explains learning and behaviour through observation of others and the environment.
• Self-efficacy is the belief in one's ability to manage prospective situations.
• People learn by observing others, especially in social situations.
• Behaviour is influenced by personal factors, environment, and the actions of others.
• Motivation is also influenced by self-efficacy, goals, and values.
• This theory can be used for health behaviours, media influence, and global issues such as climate change, population growth, poverty reduction, and gender equality.

Implementation Intentions

• Intentions are more likely to be acted on when accompanied by "if/then" plans.
• Desired behaviours are integrated into a specific plan, making them more efficient, immediate, and automatic.
• Health models are better at predicting behaviour than explaining it.
• The relationship between intention and behaviour is often unstable.
• Whether someone follows through with intentions depends on various factors.

Dual Models

• Reflective mode: slow, rule-based, accessed intentionally, involves knowledge of values and probabilities, and self-regulation.
• Impulsive mode: associations acquired through experience.

Connecting Threads

• Interventions should promote positive social cognitions.
• Attitudes towards costs and benefits, as well as efficacy, are weighed.

How can we ensure intentions generate action?

• How can we prompt health behaviour?

COM-B Framework

• This framework proposes three components: capability, opportunity, and motivation.
• Leaders, policymakers, and behavioural scientists can understand why behaviours occur and how to promote change by assessing these components.
• Capability refers to psychological and physical ability to participate in an activity.
• Opportunity refers to external factors enabling behaviour.
• Motivation refers to cognitive processes driving behaviour.

Motivational Interviewing

• A counselling style that helps individuals change behaviours by increasing their motivation.
• Ambivalence (uncertainty) is a key component.
• Techniques include establishing rapport, eliciting change talk, and developing discrepancy.
• Change talk involves expressing reasons for change (desire, ability, reason, need, commitment).

Applications in Health Promotion

• Clinical health psychologists, behavioural counsellors, and applied health psychologists play roles in promoting behaviours via interventions.
• Public health professionals, researchers, and organisations involved in health promotion (such as the UK's Behavioural Insights Team) are also involved.
• Occupational health psychology focuses on work-related interventions, including factors like work design, training, ergonomic programs, health education, supportive social and physical environments, integration into company benefits to promote health and safety, employee assistance programs and employee screenings.

Self-Determination Theory

• Empirically based theory focusing on motivation, psychological needs, and wellness.
• Important for understanding how individuals' motivations and behaviours can be influenced by external factors (like others).
• Addresses how to facilitate (or hinder) motivation, using various strategies.

Behavioural Change Techniques (BCTs)

• These are the active ingredients in behavioural interventions to change behaviour.
• They are observable and replicable components designed to alter behaviour.
• These are grouped within a taxonomy with 93 individual techniques, within 16 categories.
• These help researchers design, conduct, interpret, and execute interventions.

Week 3 - Hagger and Weed Discussion

• The article discusses the effectiveness of behaviour change interventions grounded in theory, focusing on the efficacy of population-level interventions.
• One perspective argues for evidence based on large scale effectiveness trials as sufficient support.
• The other perspective emphasizes the need for further research, using implementation science to develop more effective real-world interventions across entire populations.